Ethics expendable in times of economic crisis?

I'm not suggesting that my two anecdotes can prove anything one way or another, but I wonder nevertheless whether it's purely coincidental that in times of economic crisis ethics, and more specifically bioethics is on funders' chopping blocks. At the University of Tennessee Health Science Center the Department of Human Values and Ethics, one of the oldest medical ethics programs in North America has been proposed by the medical school dean to be closed down. Its three faculty would likely lose their jobs if this came about. The dean proposed that their teaching and research be taken over by interested medical school faculty or medical practitioners. The university's endowment lost a lot of cash in the current economic meltdown, so money needs indeed to be saved, it seems. The idea though that ethics is something that could 'just' be taken over and done by someone with a strong interest or strong feeling about medical ethics is remarkable.

On last count we've had some 34 or 35 ISI (Web of Science) listed peer reviewed English language journals (and many more in other languages) serving the highly prolific academic research community in bioethics. Some of these journals have higher impact factors than biomedical journals of good international standing. Indeed, the number of excellent submissions received by some of these journals is so high that these journals publish on a monthly basis high quality peer reviewed bioethics content. Yet at the University of Tennessee a medical school dean believes work in this area could be done by someone with some kind of interest in medical ethics. It is somewhat doubtful that a similar attitude would be taken if it was pathology or surgery that's on the line. Ethics, in other words, seems to lend itself more easily to taking short-cuts when money is in short supply.

Well, in New Zealand the government announced that it will disbandon its National Bioethics Council to save money. The country's small bioethics council has produced during its life-time a whole range of excellently researched position papers on a whole range of different contentious issues, usually taking well-informed and sensible positions. I wonder whether it's really a money issue here that's at play or whether someone in power is using the economic crisis to get rid of folks saying things that the powers that are are uncomfortable with?

Friends in Need - why not lend em a helping hand...

To our colleagues in bioethics:

We need your help. We need you to write letters, and we need it fast.

Here at the University of Tennessee medical school, the Dean has informed us that he intends to eliminate our entire department. Last summer he informed our chair, Dr. Terry Ackerman, that he wanted to do this, and now the machinery to effect his plan is in motion.

Earlier today the UT Board of Trustees approved a revised policy for "discontinuing academic units," thereby activating the process in earnest. A final decision about us will ultimately require the approval of the Chancellor at this campus, the President of UT, and finally the Board of
Trustees.

UT's medical ethics department ("Human Values and Ethics") is one of the oldest in the country. It began as a program in the mid-'70s and became a full-fledged department of the medical school in the mid-'80s. All three of us (Terry Ackerman, Carson Strong and Haavi Morreim) are tenured at the rank of professor and, other than "for cause," the only way that tenured faculty
can be removed is if their positions are eliminated.

Here are the dean's exact and complete words, as communicated to the Trustees, for including our department in his list of units to be discontinued:

"Primary goals of this department are to teach and do research to increase awareness of ethical and moral issues associated with healthcare. Human Values & Ethics, with 3 tenured faculty, is under consideration for discontinuation as it has minimal funded research programs and limited
teaching of medical students. Training of human values and ethics is necessary in medical school; however this will continue to be done primarily by experienced physicians as students go through clinical rotations. Immediate plans call for retaining one faculty at half-time to
coordinate this training. Long-term effects of discontinuance on UT and the State of Tennessee are anticipated to be minimal."

First problem: the Dean's proposed alternative is a clear violation of LCME standards (Liaison Committee on Medical Education) for accrediting medical schools. In ED-23 and ED-17A (http://www.lcme.org/functions2008jun.pdf,), LCME requires that students receive ethics instruction in preclinical years, and *formally* during clinical rotations. The dean's plan eliminates preclinical instruction and provides only informal teaching during clinical
rotations. To our knowledge, there are no MDs or other PhDs who have any advanced qualifications in ethics at this institution.

Second problem: contrary to the Dean's statement, our primary goal is not merely to "increase awareness." We co-teach a required course for the first- and second-year students that has a major ethics component; conduct seminars for third-year students rotating through pediatrics and ob/gyn; and participate extensively in clinical teaching during regular patient-focused rounds and conferences for such departments as pediatrics, ob/gyn, and internal medicine. We also have a substantial involvement in teaching residents.

Third problem: the dean's comment on research does not discuss the quality of our work, only its lack of extramural funding. We have informed him that funding for research in bioethics is very limited, particularly as compared to the monies available for medical research; also, that much of what is available is directed toward social science exploration of topics of
relevance to ethics (e.g. empirical studies of informed consent), rather than the more purely philosophical and ethics-oriented research that this department has historically produced.

We ask you to write letters to the Chancellor, to the President and to the Trustees. Their names and addresses are just below‹one letter will do it for all the Trustees. We have known our campus' Chancellor, Dr. Pat Wall, to be a fine human being with a strong sense of value and priorities. He is no moral coward. We believe he in particular will take seriously your
thoughtful expressions. Letters to the President and Trustees will provide him with important reinforcement.

The content of the letter can be the same for each recipient, but: *sending one letter to one person will not be as helpful as sending that letter to all three (Chancellor, President, Trustees);
*sending one letter from a department/program as a whole is good, but not nearly as good as if each willing member of the department sends letters.

We would deeply appreciate an earnest letter explaining why saving money by eliminating ethics is unwise for a medical school. It would also be helpful to comment on our national reputations, as that is one of the factors to be considered.

Please help. We send our heartfelt thanks to you all.

Terry Ackerman
Carson Strong
Haavi Morreim

==============================

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Chancellor:
Pat Wall, M.D.
Chancellor, UTHSC
409 Hyman Administration Building
University of Tennessee Health Science Center
Memphis, TN 38163

President:
Jan Simek, Ph.D.
Interim President, University of Tennessee
Office of the President
831 Andy Holt Tower
University of Tennessee
Knoxville, TN 37996-0180

Trustees:
You can use one letter for all trustees. When your letter is received in the
Trustees' office, they'll scan it an email it to all members.

Address:
Board of Trustees Office
University of Tennessee
719 Andy Holt Tower
Knoxville TN 37996-0170

If you wish to do so, it would be helpful to us if you would send a copy of
your letter to:
Dr. Terrence F. Ackerman
Chair, Dept. of Human Values and Ethics
910 Madison Avenue, Suite 311
University of Tennessee Health Science Center
Memphis TN 38163